American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 382.e1-382.e8 , April 2008

Twin-to-twin transfusion syndrome: an antiangiogenic state?

Presented at the 28th Annual Meeting of the Society for Maternal–Fetal Medicine, Dallas, TX, Jan. 28-Feb. 2, 2008.

  • Juan Pedro Kusanovic, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Roberto Romero, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI
    • Corresponding Author InformationReprints: Roberto Romero, MD, Perinatology Research Branch, NICHD, NIH, DHHS, Wayne State University/Hutzel Women’s Hospital, 3990 John R, Box 4, Detroit, MI 48201.
    • ,
  • Jimmy Espinoza, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Jyh Kae Nien, MD

      Affiliations

    • Center for Perinatal Diagnosis and Research (CEDIP), Sotero del Rio Hospital, P. Universidad Catolica de Chile, Puente Alto, Chile
    • ,
  • Chong Jai Kim, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • Department of Pathology, Wayne State University, Detroit, MI
    • ,
  • Pooja Mittal, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Sam Edwin, PhD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • ,
  • Offer Erez, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • ,
  • Francesca Gotsch, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • ,
  • Shali Mazaki-Tovi, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Nandor G. Than, MD, PhD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • ,
  • Eleazar Soto, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Natalia Camacho, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI
    • ,
  • Ricardo Gomez, MD

      Affiliations

    • Center for Perinatal Diagnosis and Research (CEDIP), Sotero del Rio Hospital, P. Universidad Catolica de Chile, Puente Alto, Chile
    • ,
  • Ruben Quintero, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL.
    • ,
  • Sonia S. Hassan, MD

      Affiliations

    • Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, and Detroit, MI
    • Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI

Received 2 December 2007 ,Revised 14 January 2008 ,Accepted 6 February 2008.

  • Image Result

    Median maternal plasma concentrations of soluble Endoglin (s-Eng) among patients with monochorionic-diamniotic pregnancies with and without TTTS between 16 and 26 weeks of gestation

    Patients with TTTS

    Median maternal plasma concentrations of soluble Endoglin (s-Eng) among patients with monochorionic-diamniotic pregnancies with and without TTTS between 16 and 26 weeks of gestation

    Patients with TTTS had a significantly higher median plasma concentration of s-Eng (14.8 ng/mL [IQR: 9.6-33.5] vs 7.8 ng/mL [IQR: 6.7-9.5]; P < .001) than those without TTTS.

    Kusanovic. Twin-to-twin transfusion syndrome. Am J Obstet Gynecol 2008.

  • Image Result
    Median maternal plasma concentrations of soluble vascular endothelial growth factor (sVEGFR-1) among patients with monochorionic-diamniotic pregnancies with and without TTTS between 16 and 26 weeks of

    Median maternal plasma concentrations of soluble vascular endothelial growth factor (sVEGFR-1) among patients with monochorionic-diamniotic pregnancies with and without TTTS between 16 and 26 weeks of gestation

    Patients with TTTS had a significantly higher median plasma concentration of sVEGFR-1 (6383.1 pg/mL [IQR: 4874.5-18,047.8] vs 3220.1 pg/mL [IQR: 2310.1-5172.1]; P < .001) than those without TTTS.

    Kusanovic. Twin-to-twin transfusion syndrome. Am J Obstet Gynecol 2008.

  • Image Result
    Median maternal plasma concentrations of placental growth factor (PlGF), respectively, among patients with monochorionic-diamniotic pregnancies with and without TTTS between 16 and 26 weeks of gestati

    Median maternal plasma concentrations of placental growth factor (PlGF), respectively, among patients with monochorionic-diamniotic pregnancies with and without TTTS between 16 and 26 weeks of gestation

    Patients with TTTS had a significantly lower median maternal plasma concentration of PlGF (115.5 pg/mL [IQR: 51.9-357.4] vs. 359.3 pg/mL [IQR: 224.6-693.9]; P = .002) than those without TTTS.

    Kusanovic. Twin-to-twin transfusion syndrome. Am J Obstet Gynecol 2008.

 This research was supported in part by the Intramural Research Program of the National Institute of Child Health and Human Development, NIH, DHHS.

 Cite this article as: Kusanovic JP, Romero R, Espinoza J, et al. Twin-to-twin transfusion syndrome: an antiangiogenic state? Am J Obstet Gynecol 2008;198:382.e1-382.e8.

PII: S0002-9378(08)00152-X

doi: 10.1016/j.ajog.2008.02.016

American Journal of Obstetrics & Gynecology
Volume 198, Issue 4 , Pages 382.e1-382.e8 , April 2008

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